Citation Nr: 18144478 Decision Date: 10/24/18 Archive Date: 10/24/18 DOCKET NO. 16-22 456 DATE: October 24, 2018 ORDER Entitlement to service connection for posttraumatic stress disorder (PTSD) with specified impulse control disorder and insomnia is granted. REMANDED Entitlement to a total disability rating due to unemployability (TDIU) is remanded. FINDING OF FACT Resolving all doubt in the Veteran’s favor, the record evidence corroborates his account of in-service stressors which have been medically related to his PTSD. CONCLUSION OF LAW The criteria for entitlement to service connection for PTSD have been met. 38 U.S.C.§§ 1110, 1131, 5107; 38 C.F.R. §§ 3.102, 3.303, 3.304. REASONS AND BASES FOR FINDING AND CONCLUSION The Veteran served on active duty with the U.S. Navy from September 1966 to December 1968. The Board notes that the Veteran fied a substantive appeal to the July 2018 statement of the case (SOC) in August 2018. These issues have yet to be certified to the Board and will be decided in a future decision. Entitlement to service connection for posttraumatic stress disorder (PTSD) with specified impulse control disorder and insomnia. The Veteran asserts that he has PTSD due to his military service. Based on the following, the Board finds that service connection for PTSD is warranted. Entitlement to service connection for PTSD requires: (1) medical evidence diagnosing the condition in accordance with 38 C.F.R. § 4.125(a); (2) a link, established by medical evidence, between current symptoms and an in-service stressor; and (3) credible supporting evidence that the claimed in-service stressor occurred. 38 C.F.R. § 3.304. If the evidence establishes that the Veteran engaged in combat with the enemy and the claimed stressor is related to that combat, in the absence of clear and convincing evidence to the contrary, and provided that the claimed stressor is consistent with circumstances, conditions, or hardships of the Veteran’s service, the Veteran’s lay testimony alone may establish the occurrence of the claimed in-service stressor. 38 C.F.R. § 3.304(f); West v. Brown, 7 Vet. App. 70 (1994). If the Veteran did not engage in combat with the enemy, or if the claimed stressors are not related to combat, the Veteran’s testimony alone is not sufficient to establish the occurrence of the claimed stressors, and those stressors must be corroborated by credible supporting evidence. Cohen v. Brown, 10 Vet. App. 128 (1997). Service connection for PTSD may be granted if the evidence demonstrates (1) a current diagnosis of PTSD (rendered by an examiner specified by the regulation); (2) an in-service stressor consistent with the places, types, and circumstances of service (satisfactorily established by lay testimony) that has been medically related to the Veteran’s fear of hostile military or terrorist activity by a VA psychiatrist or psychologist, or one contracted with by VA; and (3) evidence that the Veteran’s PTSD symptoms have been medically related to the in-service stressor by a VA psychiatrist or a psychologist, or one contracted with by VA. Stressor Determinations for Posttraumatic Stress Disorder, 75 Fed. Reg. 39,852 (July 13, 2010). When there is an approximate balance of positive and negative evidence regarding any issue material to the determination of a matter, VA shall give the benefit of the doubt to the claimant. 38 U.S.C. § 5107(b); 38 C.F.R. § 3.102. As stated by the February 2018 VA examiner, the Veteran has a current PTSD diagnosis. He reported various stressors including helping unload wounded soldiers and getting their blood on him, his ship was locked by radar several times and he feared a pending attack, and his ship was fired on by small arms but he was not in a position to return fire. The examiner noted symptoms of chronic sleep impairment, difficulty in establishing and maintaining effective work and social relationships, and inability to establish and maintain effective relationships. Ultimately, the examiner found that the Veteran met the full criteria and his first two stressors contributed to his diagnosis of PTSD. The May 2014 PTSD examiner indicated the Veteran’s reported stressors did not meet the criteria for a diagnosis of PTSD. Rather, he was diagnosed with alcohol use disorder, impulse control disorder, and unspecified depressive disorder, all unrelated to service. The examiner specified that the Veteran seemed to be focus on the secondary gain in becoming service-connected, and if he did experience PTSD, it was more likely related to his experiences as a correctional officer. The June 2014 addendum opinion indicated that the Veteran did not meet the criteria for a diagnosis of PTSD based on his symptomatology. The examiner noted that the Veteran did not know what the symptoms for PTSD were; when asked to report his symptoms, he asked for a list and offered to choose from that list. After further prompting, the Veteran reported symptoms of nightmares, depression, and rage; the examiner found that his symptoms did not fully meet the criteria for PTSD. Moreover, he experienced various assaults while working as a correctional officer, he was involved in a quasi-gang when he was younger, and experienced “extreme” discipline at the hand of his father. Even with the additional information, the examiner did not find that his symptoms met the criteria for a diagnosis of PTSD. The October 2006 examiner indicated that he met the DSM-IV criteria and diagnosed the Veteran with PTSD. However, after review of his reported stressors, the examiner noted that, although frightening, his stressors did not reach a traumatic degree of stress and therefore, his PTSD was not caused by service. Based on the foregoing, the Board finds that the evidence is at least in equipoise that the Veteran’s diagnosed PTSD is related to stressful incidents that took place in service. Accordingly affording him the benefit of the doubt the Board finds that the evidence supports a grant of service connection for PTSD. See 38 C.F.R. §§ 3.102, 3.303, 3.304. In short, the February 2018 examiner found the reported stressors to be consistent in the record and adequate to support a diagnosis of PTSD. Thus, the Veteran’s PTSD symptoms have been sufficiently linked to service. As the Board finds that service connection is warranted for PTSD, a full grant of the benefit sought on appeal has been awarded. REASONS FOR REMAND 1. Entitlement to a total disability rating due to unemployability (TDIU) is remanded. A remand is required prior to adjudication of the claim for a TDIU. Service connection for PTSD has been granted pursuant to the Board’s decision above, but the disability has not yet been rated. As the assigned rating would affect the Veteran’s potential entitlement to a TDIU under 38 C.F.R. § 4.16(a), the claim for TDIU is not yet ripe for adjudication and shall be remanded to the AOJ for readjudication pending the assignment of a rating for PTSD. The matter is REMANDED for the following action: 1. The RO should take any additional development as deemed necessary to address the claim for a TDIU-including obtaining an updated VA Form 21-8940 and referral of the TDIU for extraschedular consideration if warranted. 2. After all development has been completed, the RO should readjudicate the issue of entitlement to a TDIU pending the assignment of a rating for a service-connected psychiatric disorder. H.M. WALKER Veterans Law Judge Board of Veterans’ Appeals ATTORNEY FOR THE BOARD A. Price, Associate Counsel